Effect of needle approach to the axillary artery on transarterial axillary brachial plexus block quality

Chang, Young Jin; Lee, Dong Chul; Oh, Young Jun; Ha, Dong Hun; Lee, Mi Geum

doi:10.17085/apm.2017.12.4.357

Cited by 2 publications

(3 citation statements)

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“…But we primarily focused our study on the successful rate of all 4 nerves blockage because failure in blocking 1 nerve completely can lower the anesthesia grade if surgery is performed in an area innervated by an incompletely blocked nerve. [ 12 ] Furthermore, it was thought to be more meaningful than shortening the onset time. [ 10 ]…”

Section: Discussionmentioning

confidence: 99%

“…An increase in the volume can enhance the block quality, but the probability of LA toxicity can also increase. [ 12 ] In the current study, we used triple injections to target specific cords. However, the LA was divided so that only one-third of the total volume was injected in each of the cords.…”

Section: Discussionmentioning

confidence: 99%

“…We did not use a nerve stimulator as a tool to confirm each cord, and the block was only performed on the basis of the anatomical topography of the CC space. [ 6 , 15 ] Using the study by Chang et al, [ 12 ] we assumed that there is a consistent anatomical relationship between the 3 cords and the axillary artery (the 3 cords are in a fixed position in the CC space). We believe that a more accurate block at tolerable LA doses is possible if anatomical and technical factors are adequately considered.…”

Section: Discussionmentioning

confidence: 99%

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Efficacy of a single injection compared with triple injections using a costoclavicular approach for infraclavicular brachial plexus block during forearm and hand surgery

Lee

Jung

et al. 2020

Medicine

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Objectives: It was recently proposed that a costoclavicular (CC) approach can be used in ultrasound (US)-guided infraclavicular brachial plexus block (BPB). In this study, we hypothesized that triple injections in each of the 3 cords in the CC space would result in a greater spread in the 4 major terminal nerves of the brachial plexus than a single injection in the CC space without increasing the local anesthetic (LA) volume. Methods: Sixty-eight patients who underwent upper extremity surgery randomly received either a single injection (SI group, n = 34) or a triple injection (TI group, n = 34) using the CC approach. Ten milliliters of 2% lidocaine, 10 mL of 0.75% ropivacaine, and 5 mL of normal saline were used for BPB in each group (total 25 mL). Sensory-motor blockade of the ipsilateral median, radial, ulnar, and musculocutaneous nerves was assessed by a blinded observer at 5 minutes intervals for 30 minutes immediately after LA administration. Results: Thirty minutes after the block, the blockage rate of all 4 nerves was significantly higher in the TI group than in the SI group (52.9% in the SI group vs 85.3% in the TI group, P = .004). But there was no significant difference in the anesthesia grade between the 2 groups ( P = .262). The performance time was similar in the 2 groups (3.0 ± 0.9 minutes in the SI group vs 3.2 ± 1.2 minutes in the TI group, respectively; P = .54). Discussion: The TI of CC approach increased the consistency of US-guided infraclavicular BPB in terms of the rate of blocking all 4 nerves without increasing the procedure time despite administering the same volume of the LA.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%